Background: Eventing is an equestrian sport that tests athletes’ and horses’ skill over three phases: dressage, jumping and cross‐country. Falls during the cross‐country phase can have very serious outcomes up to and including death for both horse and athlete. Therefore, understanding risk factors associated with falls is essential for improving equine and human welfare. Objectives: To provide descriptive statistics and identify risk factors at the horse‐, athlete‐ and course‐level affecting horses competing in Fédération Equestre Internationale (FEI) events worldwide. Study design: Retrospective cohort study. Methods: Data collected by the FEI of every horse start worldwide in all international (CI), championship (CH), Olympics (OG) and World Equestrian Games (WEG) competitions between January 2008 and December 2018 were analysed. Descriptive statistics followed by univariable logistic regression to identify risk factor candidates for inclusion in the final multivariable logistic regression model. Models were constructed stepwise using a bi‐directional process and assessed using the Akaike information criterion. Results: Factors associated with increased risk of falls and or unseated rider included: higher event levels, longer course distances, more starters at cross‐country phase and less experienced horses and athletes. Main limitations: The data set is geographically comprehensive but covers only FEI competitions, not National Federation events, that is not every competition started by every individual horse. Nor does the data set include any prior veterinary information or data on training or schooling. Conclusions: This is the first large‐scale epidemiological study of cross‐country falls in FEI eventing. Results suggest that a potential risk profile can be constructed for each horse‐athlete combination prior to entering a given competition, based on individual histories and course‐level factors. This could lead to interventions that can reduce the number of falls, thus protecting equine and human welfare.

OBJECTIVE: To identify risk factors associated with race-related sudden death in Thoroughbred racehorses in the US and Canada. ANIMALS: 4,198,073 race starts made by 284,387 Thoroughbred horses at 144 racetracks in the US and Canada between 2009 and 2021. PROCEDURES: Study data were extracted from the Equine Injury Database, which contains detailed records of 92.2% of all official race starts made in the US and Canada during the study period. Forty-nine potential risk factors were analyzed using univariable and multivariable logistic regression. Cases were defined as race starts that resulted in fatality within 3 days of racing, in which at least 1 of 5 codes relating to sudden death was recorded. Fatalities due to catastrophic musculoskeletal injury were omitted from the study cohort. RESULTS: 536 race starts resulted in sudden death, an incidence rate of 0.13/1,000 starts. Fifteen risk factors were significantly associated with sudden death, including horse age and sex, season and purse of race, race distance, and horses’ recent history of injury and lay-up. Horses racing while on furosemide medication were at 62% increased odds of sudden death. CLINICAL RELEVANCE: Associations found between previous injury and sudden death suggests preexisting pathology could contribute in some cases. The association between furosemide and sudden death prompts further study to understand which biological processes could contribute to this result.

Background: The equestrian discipline of eventing tests athletes' and horses' skill over three phases: dressage, jumping and cross‐country. Falls during cross‐country can be particularly serious and result in serious or fatal injury for both horse and athlete. Cross‐country course and fence design are crucial contributory factors to safety.Objectives: To provide descriptive statistics and identify fence‐level risk factors for horses competing in Fédération Equestre Internationale (FEI) events worldwide.Study Design: Retrospective cohort study.Methods: Data were collected for every horse start worldwide in all international (CI), championship (CH), Olympics (OG) and World Equestrian Games (WEG) eventing competitions between January 2008 and December 2018 and univariable logistic regression, followed by multivariable logistic regression were applied. The final model was built in a stepwise bi‐directional process, with each step assessed by the Akaike information criterion.Results: Risk factors were identified at the fence level covering aspects of fence design and course design. Ten fence types were at increased odds of a fall occurring compared with square spread fences, and seven types were at reduced odds. Fences with an approach downhill (odds ratio [OR] 1.35, 95% confidence interval [CI] 1.19–1.52), with landing into water (OR 1.82, CI 1.62–2.01), frangible devices (OR 1.28, CI 1.15–1.41) and later elements of combined obstacles (OR 1.33 CI 1.25–1.42 for the second element, OR 1.21 CI 1.10–1.32 for later elements) were associated with increased risk of falls occurring.Main Limitations: Although the dataset covers every international competition worldwide, it does not include national‐level competitions.Conclusions: It is recommended that the most challenging fences are placed near the beginning of the course, and not in downhill or water settings. The complexity of individual elements in combined fences should be reduced. Adopting evidence‐based course design is a crucial intervention for reducing the incidence of horse falls and associated serious and fatal injuries to horse and human athletes.